The Effect of Probiotics, Prebiotics, and Synbiotics on CD4 Counts in HIV-Infected Patients: A Systematic Review and Meta-Analysis. (27th November 2020)

• Record Type: Journal Article
• Authors: Fu, Yuan-Sheng; Chu, Qin-Shu; Ashuro, Akililu Alemu; Di, Dong-Sheng; Zhang, Qi; Liu, Xue-Mei; Fan, Yin-Guang
• Other Names: dos Santos Washington L. C. Academic Editor.
• Is Part Of: BioMed research international. Volume 2020(2020)
• Publication Date: 2020-11-27
• Subjects: Medicine -- Periodicals; Biology -- Periodicals; Biotechnology -- Periodicals; Life sciences -- Periodicals; 610.5
• DOI: 10.1155/2020/7947342
• Languages: English
• ISSNs: 2314-6133

Abstract

Abstract : Background . Probiotics as a potential adjuvant therapy may improve the restoration of the intestinal CD4 + T-cell population in HIV-infected patients, whereas findings from clinical trials are inconsistent. This systematic review and meta-analysis of randomized controlled trials (RCTs) was performed to quantify the effects of probiotic, prebiotic, and synbiotic supplementation on CD4 counts in HIV-infected patients. Methods . We searched PubMed, Embase, Web of Science, Scopus, and the Cochrane Central Register of Controlled Trials for relevant articles published up to March 20, 2020. Two authors independently performed the study selection, data extraction, and risk of bias assessment. Data were pooled by using the random effects model, and weighted mean difference (WMD) was considered the summary effect size. Publication bias was evaluated by a funnel plot and Egger's test. Results . The search strategy identified 1712 citations. After screening, a total of 16 RCTs with 19 trials were included in the meta-analysis. Pooling of the extracted data indicated no significant difference between the probiotics/prebiotics/synbiotics and placebo groups on CD4 counts (WMD = 3.86, 95% confidence interval (CI) -24.72 to 32.45, P = 0.791 ). In subgroup analysis, a significant increase in CD4 counts was found in the study with high risk of bias (WMD = 188, 95% CI 108.74 to 227.26, P ≤ 0.001 ). Egger's test showed no evidence of significant publication bias (P = 0.936 ). Conclusions . In summary, the evidence for the efficacy of probiotics, prebiotics, and synbiotics in improving HIV-infected patients' CD4 counts as presented in currently published RCTs is insufficient. Therefore, further comprehensive studies are needed to reveal the exact effect of probiotics, prebiotics, and synbiotics on CD4 + cell counts.